BackgroundChildhood mortality rate is high in Nigeria. There is dearth of information on the comparison of childhood mortality probability and its causal factors in the Northern and Southern Nigeria. This study was designed to fill these gaps.MethodsNigeria Demographic and Health Survey, 2008 data was used. The first part of this study focused on women aged 15–49 who ever given birth to a child (n = 23,404), irrespective of the survival status of the child and the second part utilized all women aged 15–49 (N = 33,385). The outcome variable was experienced childhood mortality. Data was analyzed using Chi-square, logistic regression and Brass logit model.ResultsResults showed that similar patterns of children’s death were observed in the two regions, but variation existed. Childhood mortality experienced was more pronounced in the North than the South, even when the potential confounding variables were used as control. Levels of education and wealth index showed an inverse relationship with childhood death in the regions (p < 0.05). The gap in childhood mortality experienced between the poorest and richest was wider in the North than the South. There was no significant difference in the risk of childhood mortality experienced by women in the urban and rural areas in the North (p > 0.05), but the difference was significant in the South (p < 0.05). The life-table mortality levels were lower in the North than the South, an indication of higher previous childhood mortality experience in the North than in the South. Across all childhood ages, the smoothed childhood mortality probabilities were consistently higher in the North than the South.ConclusionChildhood mortality is higher in the Northern than Southern Nigeria. Improving women’s education, particularly in the North will alleviate childhood mortality in Nigeria.

BackgroundThe growth in Intimate Partner Violence (IPV) cases among couples in Nigeria has been significant in recent years. Victims, which are often females, face numerous health challenges, including early death. I examined the linkages between spousal age differences and IPV in Nigeria.MethodThe couples recode data section of the 2013 Nigeria Demographic Health and Survey was used (n = 6765). Intimate partner violence was measured using 13-item questions. Data were analyzed using the logistic regression model (α = .05).ResultsThe mean spousal age difference was 8.20 ± 5.0 years. About 23.5, 18.0, 13.5 and 4.7% of couples surveyed had experienced some form of IPV, emotional, physical and sexual violence respectively. Also, IPV prevalence was 27.0, 23.7, 22.0 and 18.7% among couples with age differences of 0–4, 5–9, 10–14 and ≥15 years respectively; this pattern was exhibited across all domains of IPV. Among women who experienced physical violence, 20.5% had only bruises, 8.0% had at least one case of eye injuries, sprains and/or dislocations, and 3.7% had either one or more cases of wounds, broken bones or broken teeth. The identified predictors of IPV were: family size, ethnicity, household wealth, education, number of marital unions and husband drinks alcohol. The unadjusted likelihood of IPV was 1.60 (C.I = 1.30–1.98, p < 0.001) and 1.35 (C.I = 1.10–1.64, p < 0.01) higher in households where the spousal age difference was 0–4 and 5–9 years respectively, than the likelihoods among those with a spousal age difference ≥ 15 years, but the strength of the association weakens when other variables were included in the model.ConclusionThe level of IPV was generally high in Nigeria, but it reduced with increasing spousal age difference. This study underscores the need for men to reach a certain level of maturity before marriage, as this is likely to reduce the level of IPV in Nigeria.

Abstract

ObjectiveTo assess the health risks associated with exposure to particulate matter (PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3).DesignThe study is an ecological study that used the year 2014 hourly ambient pollution data.SettingThe study was conducted in an industrial area located in Pretoria West, South Africa. The area accommodates a coal-fired power station, metallurgical industries such as a coke plant and a manganese smelter.Data and methodEstimate of possible health risks from exposure to airborne PM10, SO2, NO2, CO and O3 was performed using the US Environmental Protection Agency human health risk assessment framework. A scenario-assessment approach where normal (average exposure) and worst-case (continuous exposure) scenarios were developed for intermediate (24-hour) and chronic (annual) exposure periods for different exposure groups (infants, children, adults). The normal acute (1-hour) exposure to these pollutants was also determined.Outcome measuresPresence or absence of adverse health effects from exposure to airborne pollutants.ResultsAverage annual ambient concentration of PM10, NO2 and SO2 recorded was 48.3±43.4, 11.50±11.6 and 18.68±25.4 µg/m3, respectively, whereas the South African National Ambient Air Quality recommended 40, 40 and 50 µg/m3 for PM10, NO2 and SO2, respectively. Exposure to an hour's concentration of NO2, SO2, CO and O3, an 8-hour concentration of CO and O3, and a 24-hour concentration of PM10, NO2 and SO2 will not likely produce adverse effects to sensitive exposed groups. However, infants and children, rather than adults, are more likely to be affected. Moreover, for chronic annual exposure, PM10, NO2 and SO2 posed a health risk to sensitive individuals, with the severity of risk varying across exposed groups.ConclusionsLong-term chronic exposure to airborne PM10, NO2 and SO2 pollutants may result in health risks among the study population.

BackgroundUtilization of long-lasting insecticidal nets (LLIN) has been associated with reduction of malaria incidence, especially among children. The 2013 Nigeria Demographic and Health Survey revealed Osun State had the least proportion (5.7%) of under-five children (U5) who slept under LLIN the night before the survey. A study was conducted to assess caregivers’ knowledge about LLIN, utilization of LLIN and factors influencing LLIN use among U5 in Osun State, Nigeria.MethodsA cross-sectional study was carried out among 1020 mothers/caregivers of U5 selected from six communities in Osun State using a multistage sampling technique. A pre-tested interviewer administered questionnaire was used to collect information on socio-demographic characteristics, mothers’ knowledge about LLIN, ownership and utilization of LLIN and factors influencing use of LLIN in U5. Questions on knowledge about LLIN were scored and categorized into good (scored ≥ 5) and poor (score < 5) knowledge out of a maximum obtainable score of seven. Utilization of LLIN was defined as the proportion of U5 who slept under net the night before the survey. Data were analysed using descriptive statistics, Chi square test and logistic regression at α < 0.05. Transcripts from focus group discussions (FGD) were analysed for emerging themes related to caregivers’ perspectives on utilization and factors affecting use of LLIN among U5.ResultsMajority of the respondents 588 (58.3%) fall between age 25–34 years, with a mean age of 30.0 ± 6.3 years. All were aware of LLIN but only 76.1% had good knowledge and 59.0% reported use of LLIN among their U5. Reported barriers to utilizing LLIN were; heat (96.4%), reactions to the chemical (75.5%) and unpleasant odour (41.3%). These were corroborated at FGD. Those with formal education [adjusted odds ratio (aOR) = 1.4; 95% CI 1.0–2.1] and those with good knowledge of LLIN (aOR = 1.8; 95% CI 1.4–2.5) were more likely to use LLIN than their counterparts without formal education and those with poor knowledge of LLIN respectively.ConclusionsThe level of knowledge of respondents about LLIN was high and the utilization of LLIN among U5 was above average, however, it is still far below the 80% target. Efforts should be made to further improve utilization of LLIN through intensified promotion and health education.

ObjectiveTo assess the timing of modern contraceptive uptake among married and never-married women in Nigeria.DesignA retrospective cross-sectional study.Data and methodWe used nationally representative 2013 Demographic and Health Survey data in Nigeria. Modern contraceptive uptake time was measured as the period between first sexual intercourse and first use of a modern contraceptive. Non-users of modern contraceptives were censored on the date of the survey. Kaplan–Meier survival curves were used to determine the rate of uptake. A Cox proportional-hazards model was used to determine variables influencing the uptake at 5% significance level.ParticipantsA total of 33 223 sexually active women of reproductive age.Outcome measureTime of uptake of a modern contraceptive after first sexual intercourse.ResultsThe median modern contraceptive uptake time was 4 years in never-married and 14 years among ever-married women. Significant differences in modern contraceptive uptake existed in respondents’ age, location, education and wealth status. Never-married women were about three times more likely to use a modern contraceptive than ever-married women (aHR=3.24 (95% CI 2.82 to 3.65)). Women with higher education were six times more likely to use a modern contraceptive than those without education (aHR=6.18 (95% CI 5.15 to 7.42)).ConclusionsThe rate of modern contraceptive uptake is low, and timing of contraceptive uptake during or after first sexual intercourse differed according to marital status. Age and number of children ever born influenced modern contraceptive uptake among the never-married women, but religion and place of residence were associated with the probability of modern contraceptive uptake among ever-married women.

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Background Nigeria, a patriarchal society, is one of the more impoverished countries of the world and while its fertility and population growth rates are high, its modern contraceptive (MC) prevalence rate is low. The wealth status and decisionmaking power of a woman have implications on their use of MC. Studies that examined the relationship between women's empowerment, wealth index and MC use in Nigeria are scarce. Methods A national representative cross-sectional data on women of reproductive age (n = 5,098) was used. Data were analysed using Chi-square and interactive logistic regression models (α = 0.05). Results Mean age of the women was 32.9(σ = 8.0) and 23.8 % were currently using MC. Current use of MC was found to be higher among the following: Yoruba (48.5 %) than Igbo (27.3 %) and Hausa women (2.9 %); highly (36.9 %) than poorly empowered women (12.1 %); upper class (35.0 %) than lower class (5.9 %); and Christians (35.5 %) than Muslims (12.6 %; p < 0.001). Injectables and condoms were the most reported MC method currently used. In the interactive model, being in lower class and poorly empowered inhibits current use of MC. The predictors of current use of MC when wealth index and women empowerment were used either jointly or interactively in the controlled regression equation were wealth index, region, education, religion, ethnicity, family planning information access on media, receiving family planning information at health facility and living children sex composition. Conclusion Modern contraceptive prevalence rate among Nigerian women was low particularly among the lower class and poorly empowered. Strategies to improve the use of MC should target women in the lower class in Nigeria.